Factor v leiden mutation in reocclusion after intra-arterial thrombolysis.
OBJECTIVE
Reocclusion of intracranial arteries after successful recanalization is associated with poor clinical outcome. The role of Factor V Leiden mutation in intracranial arterial thrombosis/rethrombosis is unclear.


METHODS
We report the case of a patient who developed recurrent reocclusions of the middle cerebral artery after intra-arterial thrombolysis for acute ischemic stroke. The patient subsequently underwent transcatheter clot retrieval followed by successful stent-supported angioplasty of the occluded segment. He underwent a detailed workup for thrombophilia. The patient was detected to be heterozygous for Factor V Leiden mutation without any other cause for thrombophilia.


CONCLUSIONS
Factor V Leiden mutation could be a contributing etiology for reocclusion after endovascular interventions in stroke. Systematic studies looking for thrombophilic mutations in patients with arterial reocclusion might be warranted.
Kuruvilla
Abraham
A
Department of Neurology, WSU/DMC Comprehensive Stroke Program, Wayne State University School of Medicine, Detroit, Michigan 48201, USA. akuruvilla@doctor4u.com
Norris
Gregory M
GM
Manjila
Sunil
S
Xavier
Andrew R
AR
Chaturvedi
Seemant
S
D002339:Carotid Arteries / Q000473:pathology; D002533:Cerebral Angiography; D005165:Factor V / Q000235:genetics*; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000188:drug therapy / Q000473:pathology; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D011994:Recombinant Proteins / Q000627:therapeutic use; D020521:Stroke / Q000188:drug therapy* / Q000235:genetics* / Q000473:pathology; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; C095381:factor V Leiden; D005165:Factor V; D010959:Tissue Plasminogen Activator